Cancer TNM staging; Esophageal carcinoma; Worldwide collaboration
ObjectivesTo summarize the latest advances about definition, classification, and TNM stage of adenocarcinoma of esophagogastric junction (AEG).MethodThe available guidelines, consensuses, international conference proceedings, and clinical studies were reviewed and summarized.ResultsThe AEG trended to be an independent entity of malignant tumor at the special location. The previous misunderstanding of AEG definitions from the WHO needed to be corrected and unified in China. The Siewert classification was still a practical clinical approach to guiding treatment strategy, while the new draft of JGCA classification needed to be evaluated and verified in the clinical practice. By contrast, the 8th edition AJCC/UICC classification was relatively controversial in the guiding treatment strategies, mainly due to the staging system, surgical approach, and extent of lymphadenectomy of Siewert Ⅱ type AEG. Based on the available research results, the TNM staging system of the 8th edition of gastric cancer tended to be more reasonable for the Siewert Ⅱ and Ⅲ types AEG.ConclusionWith increasing incidence of AEG, more experimental and clinical studies on AEG are ongoing, and it is expected to have more optimized classification and exclusive staging system for AEG in future.
Objection To analyze the relationship between blood type and prognosis of colorectal cancer patients in the Database from Colorectal Cancer (DACCA). Methods The DACCA version selected for this data analysis was updated on January 5, 2022. The data items analysis included age, gender, blood type, tumor location, tumor pathological nature, pathological TNM (pTNM) stage, survival status and survival time. According to the ABO blood type classification, it was divided into four blood type groups: A blood type group, B blood type group, AB blood type group, and O blood type group. The overall survival (OS) and disease specific survival (DSS) were analyzed in four blood type groups, and the OS and DSS of each blood type group were analyzed in pTNM stage stratification. Results A total of3 486 rows of data were obtained from the DACCA database according to the screening conditions. There was no significantdifference in OS and DSS among blood typy A, B, AB and O group (P>0.05); At specific time points, the 1-year OS of the blood type A group was worse than that of blood type B (95.8% vs. 99.6%), the 1-year OS of the blood type B group was better than that of blood type O group (99.6% vs. 96.9%), and the differences were statistically significant (P<0.008 7), but the differences between OS and DSS in the remaining 1, 3, 5 and 10 years of patients with different blood type groups were not statistically significant (P>0.008 7). In each pTNM staging subgroup, the differences between 1, 3, 5 and 10-year OS and DSS were not statistically significant among different blood type groups (P>0.008 7). Conclusions Overall, there was no significant difference in prognosis among the blood type A, B, AB, and O groups. Comparing specific blood types and follow-up time, patients with blood type B have slightly better 1-year OS than patients with blood type A or blood type O. Comparisons between other ABO blood groups and between ABO blood groups classified by the pTNM staging subgroup did not show a difference.
Objective To establish a predictive model for long-term tumor-specific survival after surgery for patients with intermediate to advanced medullary thyroid cancer (MTC) based on American Joint Committee on Cancer (AJCC) TNM staging, by using the Surveillance, Epidemiology, and End Results (SEER) Database. Methods The data of 692 patients with intermediate to advanced MTC who underwent total thyroidectomy and cervical lymph node dissection registered in the SEER database during 2004–2017 were extracted and screened, and were randomly divided into 484 cases in the modeling group and 208 cases in the validation group according to 7∶3. Cox proportional hazard regression was used to screen predictors of tumor-specific survival after surgery for intermediate to advanced stage MTC and to develop a Nomogram model. The accuracy and usefulness of the model were tested by using the consistency index (C-index), calibration curve, time-dependent ROC curve and decision curve analysis (DSA). Results In the modeling group, the multivariate Cox proportional hazard regression model indicated that the factors affecting tumor-specific survival after surgery in patients with intermediate to advanced MTC were AJCC TNM staging, age, lymph node ratio (LNR), and tumor diameter, and the Nomogram model was developed based on these results. The modeling group had a C-index of 0.827 and its area under the 5-year and 10-year time-dependent ROC curves were 0.865 [95%CI (0.817, 0.913)], 0.845 [95%CI (0.787, 0.904)], respectively, and the validation group had a C-index of 0.866 and its area under the 5-year and 10-year time-dependent ROC curves were 0.866 [95%CI (0.798, 0.935)] and 0.923 [95%CI (0.863, 0.983)], respectively. Good agreement between the model-predicted 5- and 10-year tumor-specific survival rates and the actual 5- and 10-year tumor-specific survival rates were showed in both the modeling and validation groups. Based on the DCA curve, the new model based on AJCC TNM staging was developed with a significant advantage over the former model containing only AJCC TNM staging in terms of net benefits obtained by patients at 5 years and 10 years after surgery. Conclusion The prognostic model based on AJCC TNM staging for predicting tumor-specific survival after surgery for intermediate to advanced MTC established in this study has good predictive effect and practicality, which can help guide personalized, precise and comprehensive treatment decisions and can be used in clinical practice.